Immediate treatment of a fracture includes managing:
- internal blood loss and shock: - i.v. Haemaccel infusion
- immobilisation of the fracture: - spine: prevent further spinal cord damage with cervical splint, spinal board, sandbags and taping - shoulder: high sling such as 'figure-of-eight' - hip: place a pillow outside the leg to prevent external rotation - limb: strap to trunk or opposite limb with suitable padding and splinting. A stick or rolled newspaper can be used if purpose-built equipment is not available.
- pain relief: - morphine 10mg with 12.5mg prochlorperazine i.m. is a typical dose for a fit adult - Entonox gas is carried by most ambulances - make sure that the any splinting is appropriate - bad splinting can greatly increase pain eg for fracture of upper humerus
ref: N Lawrence et al, HB Emergencies in Gen Pract, 2e 1997